What is Depression?

Depression is a treatable medical illness marked by changes in mood, thoughts, energy and behavior that affects more than 23 million adult Americans each year. It is the most common serious brain disease in the United States.

Depression is more than the inevitable sadness or disappointment that accompanies life’s ups and downs. It is a combination of five or more recognizable symptoms that are strikingly distinct from a person’s normal range of feelings and behavior. These depressive symptoms persist for more than two weeks and interfere with daily individual and family functioning.

Depression involves the whole body, but researchers have detected it in the brain through modern imaging techniques. People with depression have an imbalance of certain brain chemicals known as neurotransmitters. This imbalance produces serious and persistent physical symptoms such as changes in sleep, appetite and energy; cognitive losses such as slowed thinking and indecisiveness; and discernible feelings like irritability, hopelessness and guilt.

Major depression is characterized by a single depressive episode that may recur during a person’s lifetime. Although distressing life events can trigger a depression, not all stressful events lead to depression, nor are all depressive episodes preceded by a stressful event.

Symptoms of Depression

Experiencing five or more of the following symptoms each day during a two-week period or symptoms interfering with work or family activities can indicate the presence of clinical depression:

• Prolonged sadness or unexplained crying spells
• Significant changes in appetite, sleep patterns
• Irritability, anger, worry, agitation, anxiety
• Pessimism, indifference
• Loss of energy, persistent tiredness
• Feelings of guilt, worthlessness
• Inability to concentrate, indecisiveness
• Inability to take pleasure in former interests, social withdrawal
• Unexplained aches and pains
• Recurring thoughts of death and suicide

Who Gets Depression?

• Fifty percent of all patients experience a depressive episode between the ages of 20 and 50. The average age of onset is about 40, although many people experience their first episode in their late teens or early adulthood (15-30), or even younger. (National Institute of Mental Health, 1998)
  
• As many as one in 33 children and one in eight adolescents have clinical depression. (Center for Mental Health Services, U.S. Dept. of Health and Human Services, 1996)
  
• People with depression are four times as likely to develop a heart attack than those without a history of the illness. After a heart attack they are at a significantly increased risk of death or second heart attack. (National Institute of Mental Health, 1998)

Research has shown major depression often co-occurs 
with other illnesses:

• 25% of cancer patients
• 10 - 27% of post-stroke patients
• 50 - 75% of eating disorder patients (anorexia and bulimia)
• 27% of individuals with substance abuse disorders (both alcohol and other substances) (above: National Institute of Mental Health, 1999)
• 8.5 - 27% of persons with diabetes. (Rosen and Amador, 1996)

Depression and the Elderly

• About six million people are affected by late life depression, but only 10% ever receive treatment. (Brown University Long Term Care Quarterly, 1997)
  
• Fifteen to 20% of US families are caring for an older relative. A survey of these adult caregivers found that 58% showed clinically significant depressive symptoms. (Family Caregiver Alliance, 1997)

Women and Depression

• Women experience depression at twice the rate of men. This 2:1 ratio exists regardless of racial or ethnic background or economic status. The lifetime prevalence of major depression is 20-26% for women and 8-12% for men. (Journal of the American Medical Association, 1996)
  
• Postpartum mood changes can range from transient "blues" immediately following childbirth to an episode of major depression and even to severe, incapacitating, psychotic depression. Studies suggest that women who experience major depression after childbirth very often have had prior depressive episodes even though they may not have been diagnosed or treated. (National Institute of Mental Health, 1999)
  
• Depression may increase a woman's risk for broken bones. The hip bone mineral density of women with a history of major depression was found to be 10-15% lower than normal for their age -- so low that their risk of hip fracture increased by 40% over 10 years. (National Institute of Mental Health, 1999)

Economic Impact of Depression

• Major depression is the leading cause of disability worldwide among persons five and older. (World Health Organization, "Global Burden of Disease," 1996)
  
• Depression’s annual toll on U.S. businesses amounts to about $70 billion in medical expenditures, lost productivity and other costs. Depression accounts for close to $12 billion in lost workdays each year. Additionally, more than $11 billion in other costs accrue from decreased productivity due to symptoms that sap energy, affect work habits, cause problems with concentration, memory, and decision-making. (The Wall Street Journal, 2001, National Institute of Mental Health, 1999)
  
• Depression ranks among the top three workplace issues, following only family crisis and stress. (Employee Assistance Professionals Association Survey, 1996)

Depression and Suicide

• Depression is the cause of over two-thirds of the 30,000 reported suicides in the U.S. each year. (White House Conference on Mental Health, 1999)
  
• For every two homicides committed in the United States, there are three suicides.
  
• The suicide rate for older adults is more than 50% higher than the rate for the nation as a whole. Up to two-thirds of older adult suicides are attributed to untreated or misdiagnosed depression. (American Society on Aging, 1998)
  
• Untreated depression is the number one risk for suicide among youth. Suicide is the third leading cause of death in 15 to 24 year olds and the fourth leading cause of death in 10 to 14 year olds. Young males age 15 to 24 are at highest risk for suicide, with a ratio of males to females at 7:1. (American Association of Suicidology, 1996)
  
• The death rate from suicide (11.3 per 100,000 population) remains higher than the death rate for chronic liver disease, Alzheimer’s, homicide, arteriosclerosis or hypertension. (Deaths: Final Data for 1998, Center for Disease Control)

Getting Treatment for Depression

Up to 80% of those treated for depression show an improvement in their symptoms generally within four to six weeks of beginning medication, psychotherapy, attending support groups or a combination of these treatments. (National Institute of Health, 1998)

Despite its high treatment success rate, nearly two out of three people suffering with depression do not actively seek nor receive proper treatment. (DBSA, 1996)

An estimated 50% of unsuccessful treatment for depression is due to medical non-compliance. Patients stop taking their medication too soon due to unacceptable side effects, financial factors, fears of addiction and/or short-term improvement of symptoms, leading them to believe that continuing treatment is unnecessary. (DBSA, 1999)

Participation in a DBSA patient-to-patient support group improved treatment compliance by almost 86% and reduced in-patient hospitalization. Support group participants are 86% more willing to take medication and cope with side effects. (DBSA, 1999)